ICAO - CAPSA. 7th CAPSCA Americas Meetings. MEXICO CITY, MEXICO 6 th 9 th September,2016.

Transcription

1 ICAO - CAPSA 7th CAPSCA Americas Meetings MEXICO CITY, MEXICO 6 th 9 th September,2016.

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3 BARBADOS

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5 BARBADOS Head of State: HM Queen Elizabeth II, Represented by the Governor-General Sir Elliott Belgrave GCMG KA Prime Minister: The Honorable Freundel Jerome Stuart QC MP Minister of Health: The Honorable John Boyce Chief Medical Officer: Dr. Joy St. John

6 Barbados is a small paradise island. Total population is approx. 275,000 Highest density population in the Americas. Total area 430 sq km Democratic & elected Government. Politically strong. Barbados dollar tied to US dollar. 1US$=2BDS$.

7 Capital : Bridgetown Population: 92,000

8 BARBADOS Language: English Religion(s): Protestant 67% (Anglican 40%, Pentecostal 8%, Methodist 7%, Roman Catholic 4%, others 12%, (e.g. Jewish, Muslims etc) none 17%. Main Religious Event: Christmas. Government: Barbados is an independent state within the British Commonwealth. It has a bicameral parliament consisting of a House of Assembly and a Senate. Executive power is vested in the Cabinet chaired by the Prime Minister.

9 Oldest Parliament in The Americas

10 MAINLY TOURISM ECONOMY

11 Turquoise blue waters

12 Aquamarine blue waters with white sandy beaches

13 Local Cruise

14 Beautiful Caves

15 Boardwalk and Esplanade

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17 PORT HEALTH IN BARBADOS

18 VISION INFECTIOUS DISEASES FREE BARBADOS

19 AIM TO MAKE OUR BEAUTIFUL COUNTRY, BARBADOS A HEALTHY, WEALTHY, GODLY AND DEVELOPED NATION BY PREVENTING INFECTIOUS DISEASES IN PORTS (POINTS OF ENTRY)

20 BARBADOS Major Ports : 3 Airport: 1 Seaports: 3

21 Bridgetown Port

22 Port St.Charles

23 Port Ferdinand

24 AIRPORT Your first stop in paradise. Small Island Busiest Airport in the Caribbean It is a major gateway to the islands of the Eastern Caribbean, including exotic tropical Barbados with high standards of IHR. ICAO CAPSCA certified Air Port. Direct international flights link the island with North & South America and Europe. Cargo flights: All over the world (Including from MEXICO) New Air Port - Modern amenities

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27 past

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29 Present -GAI Airport

30 Future - (Test Flights) The Boeing taxiing at Grantley Adams International Airport The Boeing taxiing at GAIA

31 FUNCTIONS Implementation of - Barbados Quarantine Act Enforcement of Barbados Port Health rules and regulations. ICAO - CAPSCA WHO Guidelines IHR

32 CORE CAPACITY DESIGNATED PORTS POINTS OF ENTRY (PoE) BARBADOS QUARANTINE ACT, 1947 COVERS MANY OF ARTICLES IN IHR CORE CAPACITY REQUIREMENTS ARE EXTERNALLY DRIVEN. IN ANNEX 1 IHR 2005 ARTICLES 19,20, 21,23,24,27,34 & 34 BARBADOS THE QUARANTINE ACT being revised TO SUIT IHR and ICAO - CAPSCA. ICAO- CAPSCA - Annex 6,9,11 and 13

33 BARBADOS Action Plan Based on WHO s seven (7) strategic actions to guide IHR (2005) implementation in Barbados.

34 Strategy 1 GLOBAL PARTNERSHIP

35 FOSTER GLOBAL/REGIONAL PARTNERSHIPS Barbados has established global partnerships with PAHO/WHO,CDC and CAPSCA. Attended and hosted several workshops - Regional & International. Inspection of vessels for the issuance of Ship Sanitation Certificates. Assisting neighbouring territories with their port health ( Air Port) programmes. An out front in the response to the influenza H1NI outbreak, developing a protocol on the cruise ships, Air to Sea passengers which involved vessels mailing their health declarations 24 and 12 hours before arrival in port.

36 Global Partnership Internal/International Collaboration & Technical Support -CARICOM Veterinary Agriculture Travel Trade Education Defense

37 Strategy -2 STRENGTHEN NATIONAL CAPACITY

38 Chief Medical Officer : Head IHR Focal Point, Port Health. Disease surveillance, prevention, control and response systems.- Coordinator: Senior Medical Officer (N) (Epidemiologist) The Ministry of Health has established a Disaster Management Health Response Team. Coordinator: Senior Medical Officer (S) public, private hospitals, Other stake holders and Ministry of Health.

39 Strengthened periodically since 2005 to 2015 during Cricket World Cup. SARS, Pandemic Influenza, Chickun Guniya, EBOLA and ZIKA. Training: PAHO, Sub regional work shops, CARICOM exercises. Evaluated the core capacities necessary for the public health emergencies at the points of entry. Protocols revised and modified for emerging and reemerging diseases.

40 Strategy-2 Barbados has had several sensitization sessions with local stakeholders on various aspects of the IHR. IHR assessment tools have been widely distributed among stakeholders. Deadly Infectious Disease (DID) workshops and many live simulation and table top exercises were conducted since 2009 just before the outbreak of influenza A H1N1 in Mexico to 2015 EBOLA in West Africa,2015.

41 These sessions involved a wide-cross section of stakeholders from both the private and public sectors including disaster management, tourism, international transport & trade, civil aviation, immigration, customs, agriculture & veterinary, police and defence. It was hosted by the Medical Officers of Health of the island Table top and Live Simulation exercises were conducted before and after epidemics. During EBOLA Epidemic, Surveillance, Prevention, Control and Response systems were fully activated, during this period it was assessed many times and strengthened where ever identified the gaps and finally it was a great success.

42 Assessment & Medical Care, Staff and Equipment Quarantine/Isolation STATIONS Bridgetown Port in operation Airport: Q S in operation Live simulation exercises were done for EBOLA in both ports. Quarantine and Isolation centres were modified accordingly.

43 IHR implementation at ports, airports and ground crossings PREVENTION EARLY WARNING RESPONSE Containing known public health risks Detecting relevant health events Responding to public health emergencies Routine control of Sanitary conditions at points of entry and conveyances CDC, PAHO, CARPHA Intergovernmental communication, Inspection, screening, Information and verification Support to investigation and contingency plans to adopt control measures Risk management Risk assessment Event management Conveyances inspection programmes and control measures

44 Strategy 3 Strengthen public health security in travel and transport: The risk of international spread of disease is minimized through effective and established permanent public health measures and response capacity at points of entry. The regional workshop for health security for travelers and conveyances was held in Barbados for English speaking countries. The core capacity tools were placed, assessed & tested and was successful in Barbados.

45 Core capacity requirements at all times (routine) (a) Assessment and Medical care, staff & equipment (b) Equipment & personnel for transport (e) Trained staff and programme for vector control (c) Trained personnel for inspection of conveyances (d) ensure save environment: water, food, waste, wash rooms & other potential risk areas - inspection programmes

46 Medical Equipment & Transport Transport of ill persons by Gov t & Private ambulances. G.A.I.Airport Inc: Has a special arrangement for ambulance services. EBOLA: Special Training were given to public and private ambulances by Ministry of Health and QEH ambulance services

47 Con - Strategy 3 Event Management System was adapted for use in the National Focal Points and operational guidelines were prepared and distributed to PoE, and other major departments and relevant stake holders.

48 Assessment, Care, Staff and Equipment Infectious diseases e.g. SARS, Pandemic Influenza, MERS Co-V, H7N9 and EBOLA Specially trained staff in designated places (Entry/ Exit, Cargo and Animal Importation Places). Transport vehicles are disinfected. Patients are reviewed by Port Health, Polyclinic and Queen Elizabeth Hospital staff. Cleaning and disinfected protocols were tested. (PAHO/WHO, CDC guidelines) Protocols, SPO s are developed, tested and modified to suit our condition and in place.

49 Ensure save environment: water, food, waste, wash rooms & other potential risk areas - inspection programmes INSPECTION PROGRAMMES: Water samples go to the laboratory for analysis. Regular meetings with potable water stakeholders e.g. Barbados Water Authority, (BWA) and at points of entry. Regular food handling establishment inspection programme including Barbados Flight Kitchen. (BFK). Daily Inspection Programme for PoE by the Ministry of Health and stakeholders.

50 Trained staff and Programme for Vector Control Trained staff provide vertical programmes for vector control An integrated pest management programme is being planned with EHS Vector Control for PoE including trapping to identify various vectors present at PoE. Birds in Bridgetown Port

51 Strategy 4 Strengthen WHO global alert and response systems The Ministry of Health has established global alert and response systems through PAHO s regional office and CARICOM Health Desk. Chief Medical Officer and Senior Medical Officers of Health and Medical officers of Health are updated periodically. Other relevant medical personnel and stake holders were sensitized periodically

52 An Alert Responsive team has been established in the Ministry of Health. The Senior Medical Officer of Health (N) and their team is responsible In an event, the Alert management team holds daily sessions to review and assess the risk/s. If it is of significance, alert notice will be released Risks assessment and response coordination of public health emergencies of international concern are updated periodically to the concerned departments.

53 Strategy - 4 Ministry of Health has established a local net work and data entry system. The risk assessment, decisions, and interventions will be carried out accordingly. All Port Health departments were connected to modern electronic facilities. (e.g. High speed internet and tele-communications devices)

54 STRATEGY 5 Strengthen the management of specific risks: Systematic international and national management of the risks known to threaten international health security. Influenza, meningitis, yellow fever, SARS, poliomyelitis and food contamination, MERS Co-V, H7N9 and EBOLA risk managements were strengthened. Chemical and radioactive substances risk managements activities are on the way with concerned stake holders.

55 Strategy 5 Strengthen the management of specific risk. Barbados established National and International management of risks which threaten international security. e.g. H1N1 pandemic, EBOLA and ZIKA. Epidemiology and risk assessment and intervention management team has been established during the pandemic season and recently with EBOLA epidemic season. A special guidelines and protocols were prepared for port Health during Ebola Hemorrhagic disease..

56 Management of Specific Risks Specific risks assessment will be done by the Port Health Department For further medical assistance, the passengers will be sent to Queen Elizabeth Hospital (QEH), private hospitals, Primary Health Care Institutions (Polyclinics) or General physicians. Specific Risks assessment protocols are developed and are in place by Health Promotion Unit.

57 Strategy 6 Legal Issues and Monitoring Barbados is well aware of the legal mechanisms set out by the WHO and ICAO. Sustain rights, obligations and procedures Ministry of Health Officials attended the first workshop of legal advisers from English-speaking Caribbean countries was held in Barbados in The Ministry officials determined the priority areas WHO guidelines and decided to accelerate the amendment process with the Attorney General s office and PAHO soon.

58 Good Environment & Human Rights

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60 Called by many "the most beautiful spot on earth" with the most dramatic setting in the Caribbean Spectacular powder-soft white sand that can look pink in certain lights, and endless ocean views. CRANE - It is one of top ten beaches of the world- Life Styles of the Rich and Famous

61 STRATEGY 6 Sustain rights, obligations and procedures New legal mechanisms as set out in the Regulations which are fully developed and upheld; all professionals involved in implementing IHR (2005) have a clear understanding of, and sustain, the new rights, obligations and procedures laid out in the Regulations.

62 STRATEGY 7 Conduct studies and monitor progress: In Barbados, indicators are identified and collected regularly to monitor and evaluate IHR (2005) and ICAO - CAPSCA implementation. Port Health Reports are delivered to the Ministry of Health periodically. The Ministry of Health reports on progress to the World Health Assembly.

63 Radio Nuclear Implementation on the way

64 Existing Law/Ordinance/Bill Related to Radiation Sources Radiation Protection Act CAP 353A 1971 Customs Act 1963 as amended 2010 Miscellaneous Controls (Importation and Exportation of Goods) (Prohibition) (Radioactive Materials) Regulations, 2004, Customs (List of Prohibited and Restricted Imports and Exports) Order, 2009, paragraphs 3, 5(2), Second Schedule BARBADOS 64

65 Existing Regulations Related to Radiation Sources Local Hospital Radiation Rules 2004 Importation License granted by the Environmental Protection Department (permission given through the Miscellaneous Customs Act) BARBADOS 65

66 Radiation Sources- Main Gaps and Challenges Most of the sources used in industrial applications are owned by private companies The number, type, activity and quantity of radioactive sources are not well known No Regulatory Laws exist to govern the usage, monitoring, storage, transportation and disposal No systems and resources for regulation BARBADOS

67 Work Plan and Technical Cooperation Plans for future uses of radioactive sources Employ Survey method and needs assessment Institutional Strengthening through the establishment of the National Regulatory Authority ( e.g. Develop an action plan, human resources, financing, technical personnel, monitoring equipment, training) Strategic plan Establish Cooperation with International Atomic Energy Agency (IAEA) BARBADOS 67

68 REST & RELAXATION in Comfort BARBADOS

69 THANK YOU Dr. R. A. MANOHAR SINGH MEDICAL OFFICER OF HEALTH -PORTS BARBADOS. WEST INDIES